72 - Freie Mitteilung
Bariatry & hernia I
16. Mai 2019, 17:30 - 19:00, Bellavista 3+4, 6. OG
Impact of training a bariatric surgeon on a primary bariatric center
B. Blaser, C. Darbellay, G. Giudicelli, M. Diana, M. Worreth, A. Saadi, Presenter: B. Blaser (Neuchâtel)
Laparoscopic Roux-Y-Gastric Bypass (LRYGB) is the most performing bariatric procedure in Switzerland. It is a technically demanding procedure with a debated learning curve. To be certified as bariatric surgeon, the Swiss Society for the Study of morbid Obesity (SMOB) request a minimal of 50 procedures. This study aime to examine the benefit for a primary bariatric center to train a second bariatric surgeon.
Between 2015 and 2017, 170 standard consecutive LRYGB for patients with BMI between 35 and 50 kg/m2 were retrospectively included. We analysed the following variables between trainer surgeon (TS) and trainee surgeon (tS) : operative time (OT), BMI loss at 18 months from surgery and 30 days complications each year. For the center, same data were compared between 2015, 2016 and 2017.
OT and BMI evolution were similar in both group (TS vs tS), reaching mean 128.9min (+/-36.3) vs 137.3 (+/-27.4) in 2015, 101.8 (+/-28.7) vs 119.2 (+/-37.3) in 2016 and 94 (+/-33.5) vs 90.5 (+/-27.6) in 2017 for OT. The mean BMI were 26.8 kg/m2 (+/-7.2) vs 26.6 (+/-4.3) in 2015, 26 (+/-3.2) vs 25.1 (+/-2) in 2016 and 29.2 (+/-3.1) vs 23.9 (+/-4.4) in 2017. For the center, mean OT were improved each year 132.3min (+/-33), 110.5 (+/-34) and 92.6 (+/-31.1) for 2015, 2016 and 2017 respectivly with p=0.0001. There was no difference for BMI loss and 30 days complications were similar.
Same outcomes are observed for trainer and trainee bariatric surgeons from the begining of the formation. Training a second bariatric surgeon improved mean operative time with same results for BMI loss at 18 months. Those results suggest that technical skills increase for team of surgeons and could be an essential step to reach a reference center accreditation.